Physical activity and social isolation in community-dwelling older adults
thesis
posted on 2017-04-04, 23:27authored byLauren Maggie Robins
Population
ageing is a major global health concern due to the rising numbers of people
living longer. With increased age there is a likelihood of decline in physical
health and mental wellbeing. Social isolation in particular has been identified
as leading to a number of detrimental health outcomes and can create an
increased demand on health services. Conversely, adequate social relationships
have been demonstrated to be protective against many negative health
consequences.
The objective of this thesis was to investigate whether there
is potential for physical activity interventions to have an effect on reducing
social isolation amongst community-dwelling older adults. It sought to explore
older adult perspectives of the benefits of and barriers to both group- and
home-based physical activity interventions, investigated correlations between
physical activity, including both recreational and household-based types, and
social isolation and between physical capacity and social isolation.
Additionally, whether older adults discuss social isolation with their health
professional was explored.
Six papers were developed utilising qualitative and
quantitative designs to address the aims of the thesis. The first paper was a
systematic review and meta-analysis of existing research that investigated the
impact of physical activity interventions on social isolation amongst
community-dwelling older adults. The second paper was a qualitative analysis of
older adults’ responses to questions regarding the benefits of and barriers to
participating in group- and home-based falls prevention exercise programs. The
third paper was a cross-sectional analysis of the relationship between
recreational, household-based, and total physical activity and social
isolation. This paper investigated whether there was an association between
participation in group- or home-based falls prevention exercise and social
isolation. The fourth paper was a cohort study nested within a randomised
controlled trial. This paper measured the correlation between physical capacity
and physical activity and between physical activity and social isolation over
12 months in a sample of adults with chronic conditions. The fifth paper was a
cohort study of older community-dwelling adults following discharge from
hospital and examined the effect of physical activity levels (recreational,
household-based and total) on social isolation and the impact of physical capacity
on social isolation. The final paper was a qualitative investigation of whether
older adults reported discussing social isolation with their health
professional, the details of what was discussed or the reasons such
conversations had not occurred.
Recommendations were able to be made based on the findings of
these six papers for physical activity interventions to address social
isolation. First, interventions targeted at improving physical capacity and
increasing levels of household-based physical activity were demonstrated to
present a viable option for reducing social isolation. Second, the current lack
of discussion between health care professionals and older adults would need to
be remedied in order to promote a successful intervention. Finally, health care
practitioners referring older adults to physical activity-based interventions
might want to consider the patients’ preferences for group-based interventions
compared to those they might perform alone, based on their perspective of
whether the social element of group-based physical activity presents a benefit
or a barrier to participating.